title: Fine-motor skills testing and prediction of endovascular performance.
abstract: BACKGROUND
  Performing endovascular procedures requires good control of fine-motor digital movements and hand-eye coordination. Objective assessment of such skills is difficult. Trainees acquire control of catheter/wire movements at various paces. However, little is known to what extent talent plays for novice candidates at entry to practice.
  
  
  OBJECTIVE
  To study the association between performance in a novel aptitude test of fine-motor skills and performance in simulated procedures.
  
  
  METHODS
  The test was based on manual course-tracking using a proprietary hand-operated roller-bar device coupled to a personal computer with monitor view rotation. A total of 40 test repetitions were conducted separately with each hand. Test scores were correlated with simulator performance. Group A (n = 14), clinicians with various levels of endovascular experience, performed a simulated procedure of contralateral iliac artery stenting. Group B (n = 19), medical students, performed 10 repetitions of crossing a challenging aortic bifurcation in a simulator.
  
  
  RESULTS
  The test score differed markedly between the individuals in both groups, in particular with the non-dominant hand. Group A: the test score with the non-dominant hand correlated significantly with simulator performance assessed with the global rating scale SAVE (R = -0.69, P = 0.007). There was no association observed from performances with the dominant hand. Group B: there was no significant association between the test score and endovascular skills acquisition neither with the dominant nor with the non-dominant hand.
  
  
  CONCLUSIONS
  Clinicians with increasing levels of endovascular technical experience had developed good fine-motor control of the non-dominant hand, in particular, that was associated with good procedural performance in the simulator. The aptitude test did not predict endovascular skills acquisition among medical students, thus, cannot be suggested for selection of novice candidates. Procedural experience and practice probably supplant the influence of innate abilities (talent) over time.
authors.affiliation: Centre for Clinical Education, University of Copenhagen and Capital Region of Denmark, Denmark.
authors.forename: Bo
authors.initials: B
authors.lastname: Bech
authors.forename: Lars
authors.initials: L
authors.lastname: Lönn
authors.forename: Torben V
authors.initials: TV
authors.lastname: Schroeder
authors.forename: Charlotte
authors.initials: C
authors.lastname: Ringsted
mesh_terms: D017130:Angioplasty; D001077:Aptitude Tests; D004292:Dominance, Cerebral; D057510:Endovascular Procedures; D005544:Forecasting; D009048:Motor Skills; D015607:Stents; D013337:Students, Medical
keywords: Vascular; angiography; angioplasty; computer applications – virtual imaging; education; stents